Non-Arteritic Anterior Ischaemic Optic Neuropathy Associated with Semaglutide use

Abstract

Presentation
Non-arteritic ischaemic optic neuropathy (NAION) is a common cause of acute, painless monocular visual disturbance in older adults. This case discusses a woman in her 70s with vascular risk factors who presented with a three-day history of progressive left sided visual disturbance. Examination demonstrated a left relative afferent pupillary defect and inferior quadrantopia.

Diagnosis
Haematological investigations and neuroimaging were unremarkable. Formal ophthalmological assessment demonstrated superior optic disc swelling with an inferior visual field defect, consistent with NAION.

Treatment
The patient had been taking semaglutide, as prescribed, for the six months prior to presentation. This was identified as a potential contributory agent and was discontinued. Visual acuity partially improved following cessation of semaglutide.

Discussion
This case seeks to highlight a possible association between semaglutide use and NAION. Although causality remains unproven, it underscores the importance of pharmacovigilance when manging patients presenting with ophthalmological symptoms.